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Pleural effusion exudate

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https://www.readbyqxmd.com/read/28630242/tumour-necrosis-factor-tnf-inhibitor-induced-isolated-pleural-granulomas-a-rare-adverse-effect
#1
Muhammad Sajawal Ali, Rose Franco, Dheeraj Dhotre, Nagarjun Rao
A 53-year-old man with a history of Crohn's disease on infliximab, presented with several weeks of cough and dyspnoea. He had a right-sided pleural effusion, found to be exudative with lymphocytic predominance. He underwent right-sided video-assisted thoracic surgery (VATS) with biopsies and pleurodesis. Histopathology showed pleural-based non-caseating granulomas with unremarkable lung parenchyma. Cultures were only positive for Propionibacterium acnes 8 months later, he was found to have a left-sided exudative, lymphocytic predominant pleural effusion...
June 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28626164/diagnostic-significance-of-measuring-vascular-endothelial-growth-factor-for-the-differentiation-between-malignant-and-tuberculous-pleural-effusion
#2
Hak-Ryul Kim, Byoung-Ryun Kim, Rae-Kil Park, Kwon-Ha Yoon, Eun-Taik Jeong, Ki-Eun Hwang
Malignancy and tuberculosis are common causes of lymphocytic exudative pleural effusion. However, it is occasionally difficult to differentiate malignant pleural effusion from tuberculous pleural effusion. Vascular endothelial growth factor (VEGF) is a critical cytokine in the pathogenesis of malignant pleural effusion. Endocan is a dermatan sulfate proteoglycan that is secreted by endothelial cells. Importantly, endocan mediates the vascular growth-promoting action of VEGF. The aim of this study was to evaluate the diagnostic significance of VEGF and endocan in pleural effusion...
2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28616270/urinothorax-a-systematic-review
#3
María E Toubes, Adriana Lama, Lucía Ferreiro, Antonio Golpe, José M Álvarez-Dobaño, Francisco J González-Barcala, Esther San José, Nuria Rodríguez-Núñez, Carlos Rábade, Tamara Lourido, Luis Valdés
BACKGROUND: The characteristics of patients with urinothorax (UT) are poorly defined. METHODS: A systematic review was performed searching for studies reporting clinical findings, pleural fluid (PF) characteristics, and the most effective treatment of UT. Case descriptions and retrospective studies were included. RESULTS: The review included 78 studies with a total of 88 patients. Median age was 45 years, male/female ratio was 1.6:1 and in 76% of cases the etiology was trauma...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28609772/lymphoproliferative-disorders-of-the-lung
#4
Raphaël Borie, Marie Wislez, Martine Antoine, Jacques Cadranel
This review aims to describe some of the most frequent lymphoproliferative disorders arising from the lung: pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma, lymphomatoid granulomatosis (LG), multicentric Castleman disease (MCD), primary effusion lymphoma (PEL), and nodular lymphoid hyperplasia (NLH). Primary pulmonary lymphoma is defined as a clonal lymphoproliferative disorder affecting one or both lungs, without extrapulmonary involvement 3 months after diagnosis, and includes pulmonary MALT lymphoma and LG...
June 14, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28606378/predictors-of-talc-slurry-pleurodesis-success-in-patients-with-malignant-pleural-effusions
#5
P S Santos, M A Marques, C Cruz, H Monteiro, F Fradinho
INTRODUCTION: Malignant pleural effusions are an important burden of malignant disease. Slurry talc pleurodesis remains one of the most common and effective therapeutic options. AIM: Investigate the predictive factors related with the efficacy of this technique in malignant pleural effusions. METHODS: Retrospective analysis of all pleurodesis performed during a 10-year period in a Pulmonology Unit. All demographic and clinical data were collected, including the histologic tumoral type and the biochemical, microbiological and cytological fluid features...
June 9, 2017: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/28507831/streptococcus%C3%A2-gordonii%C3%A2-empyema-a-case-report-and-review-of-empyema
#6
Amanda M Krantz, Felicia Ratnaraj, Manasa Velagapudi, Mridula Krishnan, Nagarjuna R Gujjula, Pamela A Foral, Laurel Preheim
Streptococcus gordonii (S. gordonii) is a pioneer oral bacteria that is recognized as an agent of bacterial endocarditis. However, an extensive review of the literature revealed no reported case of S. gordonii causing empyema. We present a case of a 65-year-old male who presented with respiratory distress. Physical examination revealed several dental caries with decreased breath sounds in the bibasilar regions. A computed tomography (CT) scan of the chest and abdomen demonstrated left-sided pleural effusion and a 4...
April 12, 2017: Curēus
https://www.readbyqxmd.com/read/28491491/tuberculous-pleural-effusion-occurring-concurrently-with-asbestos-related-pleural-disease
#7
Massa Zantah, Debapriya Datta
An eighty-four-year-old man presented with progressive exertional dyspnea, productive cough and weight loss for two months. His physical exam was notable for diminished breath sounds at the right base, with dullness to percussion. Chest-x-ray showed moderate right-sided pleural effusion and bilateral calcified pleural plaques as well as diaphragmatic plaques consistent with asbestos-related pleural disease (ARPD). Pleural fluid was exudative with predominantly mononuclear cells, negative acid fast bacilli stain, negative cultures, and negative cytology for malignant cells...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28484098/fibrinous-pericarditis-secondary-to-bacterial-infection-in-a-cat
#8
Michihito Tagawa, Chihiro Kurashima, Genya Shimbo, Hiroshi Omura, Kenji Koyama, Noriyuki Horiuchi, Yoshiyasu Kobayashi, Keiko Kawamoto, Kazuro Miyahara
A three-year-old spayed domestic short-haired cat presented for evaluation of weight loss, cardiomegaly and pleural effusion. Echocardiographic examination demonstrated a thickened pericardium with mild pericardial effusion and a large volume of pleural effusion characterized by exudate. Although the cat was treated with antibiotics, the clinical symptoms did not improve. The cat developed dyspnea and died on day 7. Necropsy revealed a large amount of modified transudates ascites, pleural effusion and markedly dilated pericardium...
May 5, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/28440918/uremic-pleuritis-a-case-report-and-review-of-recurrent-exudative-pleural-effusions-in-children
#9
Matthew D McGraw, Csaba Galambos, Paul C Stillwell
Despite similar mechanisms driving pleural fluid accumulation, the causes of pleural effusions in children differ significantly from that of adults. When a pleural effusion re-occurs in an adult, literature recommends early thoracentesis, and consideration for pleuroscopy with biopsy to guide the diagnostic evaluation. In children, there is a paucity of literature for guiding management of recurrent exudative pleural effusion. We present an unusual pediatric case of uremic pleuritis with recurrent pericardial and exudative pleural effusions...
April 25, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28433200/the-case-against-performing-pleural-biopsies-for-the-aetiological-diagnosis-of-exudates
#10
J M Porcel
In most cases, the etiological diagnosis of pleural exudates does not require a pleural biopsy. However, when it is considered necessary, the biopsy should seldom be conducted using invasive methods such as thoracoscopy. Two paradigmatic examples are pleural tuberculosis and malignant effusions. In many centres, pleural fluid adenosine deaminase measurement has replaced closed pleural biopsies in the diagnosis of tuberculosis. Similarly, pathological and molecular studies on pleural fluid cell blocks or alternatively, image-guided pleural biopsies have drastically reduced the need for thoracoscopy...
April 19, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28410823/the-case-for-performing-pleural-biopsies-for-the-aetiological-diagnosis-of-exudates-yes
#11
F Rodriguez-Panadero
Pleural biopsies are especially indicated in the following circumstances: a) inconclusive pleural fluid analysis and negative sputum study, if adenosine deaminase (ADA) levels are unavailable; b) suspected multi-resistant tuberculosis; c) a need for differentiating tuberculous pleurisy (if it progresses with neutrophilia) and complicated parapneumonic effusion; d) malignant pleural effusion coexisting with very high ADA levels; e) effusion coexisting with lung cancer and negative pleural cytology; f) suspected mesothelioma; and g) need for implementing re-treatment for patients with relapse after chemotherapy...
April 12, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28399010/pleural-effusions-in-acute-idiopathic-pericarditis-and-postcardiac-injury-syndrome
#12
José M Porcel
PURPOSE OF REVIEW: Pleural effusions are frequent in the context of acute idiopathic pericarditis and following pericardiotomy, but they have seldom been characterized. This review summarizes their most relevant clinical features. RECENT FINDINGS: In acute idiopathic pericarditis, pleural effusions tend to be left-sided and, if bilateral, they are usually larger on the left. Less than 5% are unilateral right-sided. About 90% of the effusions occupy less than one-third of the hemithorax, and 99% meet Light's exudative criteria with a predominance of lymphocytes in three fourths of the cases...
July 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28353119/safety-and-feasibility-of-pleural-cryobiopsy-compared-to-forceps-biopsy-during-semi-rigid-pleuroscopy
#13
Vikas Pathak, Ray W Shepherd, Ehab Hussein, Rajiv Malhotra
BACKGROUND: Pleural biopsy is often obtained in patients with undiagnosed exudative pleural effusion during pleuroscopy. Standard forceps have been traditionally used for the biopsy. Cryoprobes are being increasingly used for transbronchial lung biopsy as they obtain larger specimens and have less crush artifact. However, the safety and feasibility of cryoprobe biopsy compared to standard forceps for pleural biopsy has not been fully assessed. OBJECTIVES: The objective of this study was to demonstrate the safety and feasibility of cryoprobe biopsy in the pleural space using semi-rigid pleuroscopy...
March 28, 2017: Lung
https://www.readbyqxmd.com/read/28320470/methimazole-associated-eosinophilic-pleural-effusion-a-case-report
#14
Pedro Gaspar-da-Costa, Filipa Duarte Silva, Júlia Henriques, Sónia do Vale, Sandra Braz, João Meneses Santos, Rui M M Victorino
BACKGROUND: Adverse reactions associated to anti-thyroid drugs include fever, rash, arthralgia, agranulocytosis and hepatitis that are thought to be hypersensitivity reactions. Five cases of pleural effusion associated to thionamides have also been reported, two with propylthiouracil and three with carbimazole. CASE PRESENTATION: We report here a case of a 75-year-old man admitted because of unilateral pleural effusion. The patient had a recent diagnosis of hyperthyroidism and 6 days after starting methimazole complained of pleuritic chest pain...
March 21, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28289482/efficacy-of-computed-tomography-ct-attenuation-values-and-ct-findings-in-the-differentiation-of-pleural-effusion
#15
Kadihan Yalçin-Şafak, Neslihan Umarusman-Tanju, Muhammet Ayyıldız, Nihal Yücel, Tamer Baysal
BACKGROUND: The aim of this study was to investigate the efficacy of computed tomography (CT) findings for characterizing pleural effusions with the use of attenuation values. MATERIAL/METHODS: One hundred and twenty eight patients with pleural effusions on thoracic CT who underwent thoracentesisis within two weeks were studied. Pleural effusions were classified as exudates or transudates according to the Light's criteria. A region of interest was placed for the measurement of Hounsfield Unit (HU) values in the area of the greatest amount of effusion on each slice of the three slices used...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28275489/medical-thoracoscopy-in-china-the-present-status-and-the-future
#16
REVIEW
Jing-Yuan Liu, Liang Xiong, Min Zhang, Shi-Yuan Shuai, Xiao-Shan Wei, Lin-Lin Ye, Qiong Zhou
Medical thoracoscopy (MT) refers to a minimally invasive procedure to inspect and perform a biopsy of the pleural space, as well as to perform therapeutic interventions, in a nonintubated patient under local anesthesia. This procedure provides the physician a window into the pleural space. Over the past two decades, MT has been developed very rapidly in China. We performed a review of the published data on MT in China, and estimated the present status, the challenges, and future perspectives of MT. From the data we conduct that MT is widely used well in China, not only in the diagnosis of exudative pleural effusions, but also in the management of pleural diseases, such as tuberculous pleural effusion, malignant pleural effusion and spontaneous pneumothorax...
February 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28237067/utility-of-cea-and-ca-15-3-measurements-in-non-purulent-pleural-exudates-in-the-diagnosis-of-malignancy-a-single-center-experience
#17
José M Porcel, Carme Civit, Aureli Esquerda, Antonieta Salud, Silvia Bielsa
OBJECTIVE: To establish the diagnostic accuracy of pleural fluid (PF) CEA and CA 15-3 in identifying malignancy, and to determine the additional value of these markers in patients with malignant pleural effusions (MPEs) with false negative results from cytological fluid examination. METHODS: PF concentrations of CEA and/or CA 15-3 were determined in 1,575 patients with non-purulent exudates, 549 of whom had confirmed MPEs, 284 probable MPEs, and 742 benign effusions...
February 22, 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/28217593/validity-of-tuberculous-pleuritis-diagnosed-in-a-resource-constrained-setting-in-dindigul-district-of-tamil-nadu
#18
Baranidharan Chennaiyan, Arun N Bhatt, Roopa Kancherla, Cijoy K Kuriakose, Anand Vimal Dev, George A Philip
CONTEXT: Majority of the Indians live in rural areas where resource constrained settings depend on cheaper and less invasive tests to diagnose extrapulmonary tuberculosis (TB). The decline in prevalence of TB in the country could affect the validity of the diagnosis. The aim was to measure validity of the pleural fluid study of proteins, lactate dehydrogenase (LDH), and cell counts in diagnosis of tuberculous pleuritis. MATERIALS AND METHODS: This was a cross-sectional study conducted in a 300 bedded secondary care hospital in rural Tamil Nadu...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28215651/behaviour-of-nucleated-cells-in-various-types-of-pleural-effusion
#19
L Ferreiro, T Pereiro, E San José, M E Toubes, J Suárez-Antelo, J M Álvarez Dobaño, F J González Barcala, N Rodríguez Núñez, A Lama, L Valdés
INTRODUCTION: To know the behavior of cellular components of pleural fluid can help focus the differential diagnosis of a pleural effusion. Our objective was to assess their composition in different types of pleural effusions and assess whether it provides relevant clinical information. PATIENTS AND METHODS: Observational, cross-sectional and retrospective study in which the cellular components of pleural effusions of different etiology were analyzed. Pleural effusions were classified as neutrophilic, lymphocytic (≥50% of each one of them), eosinophilic (≥10%) or mesothelial (>5%) and were grouped into six diagnostic categories RESULTS: 1...
February 16, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28209662/the-impact-of-between-analytical-platform-variability-on-the-classification-of-pleural-effusions-into-exudate-or-transudate-using-light-s-criteria
#20
Michael P Cornes, Andrew J Chadburn, Claire Thomas, Catherine Darby, Rachel Webster, Clare Ford, Rousseau Gama
BACKGROUND: Light's criteria are ratios of pleural fluid to serum total protein (TP), pleural fluid to serum lactate dehydrogenase (LDH) and pleural fluid LDH to the upper reference limit for serum LDH. They are used to classify pleural effusions into an exudate or transudate when pleural fluid protein is 25-35 g/L. We evaluated the impact of between analytical platforms on the classification of pleural effusions using Light's criteria. METHODS: Light's criteria were used to classify pleural effusions with fluid TP between 25 and 35 g/L into exudate and transudate...
February 16, 2017: Journal of Clinical Pathology
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